Medicare billing guides ======================= Plain-language explainers for doctors and practice staff, with the current figures. - [How Medicare benefits work: schedule fees, 75%, 85% and 100% ------------------------------------------------------------ How the MBS schedule fee becomes a Medicare benefit, when 75%, 85% or 100% applies, the greatest permissible gap, and how to work out the patient’s gap.](/guides/how-medicare-benefits-work) - [Medicare safety nets explained: original and extended (EMSN) thresholds for 2026 -------------------------------------------------------------------------------- The 2026 Medicare Safety Net thresholds, what counts towards them, how the EMSN pays 80% of out-of-pocket costs, and how EMSN benefit caps limit it.](/guides/medicare-safety-nets) - [In-hospital billing: the 75% benefit, the 25% fund benefit, and no-gap and known-gap schemes -------------------------------------------------------------------------------------------- How private in-hospital medical services are paid: the Medicare 75% benefit, the health fund’s minimum 25%, no-gap and known-gap arrangements, and informed financial consent.](/guides/in-hospital-billing-and-gap-cover) - [Bulk billing incentives and BBPIP explained: 2026 amounts by MM area -------------------------------------------------------------------- The bulk billing incentive items and amounts for each Modified Monash area from 1 July 2026, which category applies, and how the Bulk Billing Practice Incentive Program’s 12.5% works.](/guides/bulk-billing-incentives) - [The MBS multiple operation rule and surgical assistant fees ----------------------------------------------------------- How the 100%, 50% and 25% multiple operation rule works, which items it covers, how it is rounded, and how the assistant’s fee (items 51300 and 51303) is worked out.](/guides/multiple-operation-rule) - [Assignment of benefit for bulk billing: the changes from 1 July 2026 -------------------------------------------------------------------- What changed in the bulk billing assignment of benefit process on 1 July 2026: no approved form, patient-only signatures, verbal agreement until 30 June 2027, and enduring agreements.](/guides/assignment-of-benefit-2026) - [MBS telehealth rules: the eligible telehealth practitioner and phone items -------------------------------------------------------------------------- When you can bill GP telehealth items: the 12-month face-to-face rule, MyMedicare, exemptions, and why 20 and 40-minute phone consultations are for MyMedicare patients only.](/guides/mbs-telehealth-rules) - [GP chronic condition management plans: items 965 and 967 explained ------------------------------------------------------------------ The GP chronic condition management plan items that replaced GPMPs and TCAs, their fees, eligibility, how often they can be claimed, and allied health referrals.](/guides/chronic-condition-management-plans) - [Medicare billing compliance: claim time limits, records and the 80/20 rule -------------------------------------------------------------------------- The one-year claim time limit, what makes records adequate and contemporaneous, how long to keep documents, and the 80/20 and 30/20 prescribed pattern of services rules.](/guides/medicare-billing-compliance)